Exam (elaborations)

Contemporary Nursing Issues-Trends 7th Edition - Test Bank

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Nursing Test Bank

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Chapter 03: The Influence of Contemporary Trends and Issues on Nursing Education Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 7th Edition MULTIPLE CHOICE 1. A current trend is for students to be evaluated to determine whether they demonstrate competence in the actua...

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,Chapter 21: Staffing and Nursing Care Delivery Models
Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 7th
Edition

MULTIPLE CHOICE

1. Accrediting agencies such as The Joint Commission address staffing by:
a. imposing maximum staffing levels.
b. requiring a specific staff mix.
c. stipulating nurse-patient ratios.
d. looking for evidence that patients receive satisfactory care.
ANS: D
Accrediting agencies do not address minimum staffing levels; however, they do look for
evidence that patients receive adequate care, and this can occur only with adequate staffing.

DIF: Comprehension REF: p. 369

2. Customer satisfaction is primarily based on:
a. access to modern, up-to-date facilities.
b. availability of an extensive menu selection.
c. personal interactions with employees.
d. having to undergo fewer invasive procedures.
ANS: C
Interactions between employees and patients/families actually affect clinical outcomes,
functional status, and even physiologic measures of health.

DIF: Knowledge REF: p. 369

3. rNurses on a unit provide personal hygiene, administer medications, educate the patient and
family about treatments, and provide emotional support. These nurses provide patient care
based on which nursing delivery system?
a. Total patient care
b. Partnership nursing
c. Team nursing
d. Functional nursing
ANS: A
In total patient care nurses provide all aspects of patient care.

DIF: Comprehension REF: p. 370

4. A hospital converts to a system of care delivery in which RNs, LPNs, and unlicensed assistive
personnel (UAP) are responsible for implementing a specific task, such as medication
administration or personal hygiene, for the entire nursing unit. This type of delivery system is:
a. total patient care.
b. functional nursing.
c. team nursing.
d. primary nursing.

, ANS: B
In functional nursing members of the team are assigned specific tasks such as assessment or
medication administration.

DIF: Comprehension REF: pp. 370-371

5. The nurse who is responsible for following the patient from admission through discharge or
resolution of illness while working with a broad range of health care providers is called a:
a. nurse manager.
b. case manager.
c. coordinator of patient-centered care delivery.
d. team leader in team nursing care delivery.
ANS: B
The case manager, in collaboration with an interdisciplinary team, oversees the use of health
care services by clients throughout a course of illness.

DIF: Comprehension REF: p. 373

6. A patient is admitted with coronary artery disease and is scheduled for coronary artery bypass
grafting (CABG). According to the clinical pathway the patient should be extubated and
discharged from critical care the day after surgery. During surgery the patient’s oxygen
saturation decreased drastically as a result of chronic tobacco abuse. Subsequently, the patient
remained on the ventilator an additional 2 days postoperatively. According to the clinical
practice guideline for CABG, this situation represents a:
a. patient outcome.
b. variance.
c. goal.
d. standard.
ANS: B
A variance is a deviation from the planned path.

DIF: Comprehension REF: p. 375

7. A patient is admitted with pneumonia. The case manager refers to a plan of care that
specifically identifies dates when supplemental oxygen should be discontinued, positive-
pressure ventilation with bronchodilators should be changed to self-administered inhalers, and
antibiotics should be changed from intravenous to oral treatment, on the basis of assessment
findings. This plan of care is referred to as a:
a. patient classification system.
b. clinical pathway.
c. patient-centered plan of care.
d. diagnosis-related group (DRG).
ANS: B
A clinical pathway is a plan that specifies the timing and sequencing of major patient care
activities and interventions by the interdisciplinary team for a particular diagnosis, procedure,
or health condition.

DIF: Application REF: pp. 374-375

, 8. The nurse manager determines that four RNs, five LPN/LVNs, and two unlicensed assistive
personnel (UAP) are required per shift to meet the needs of the patient population on the unit,
according to acuity and census. The nurse manager is concerned with:
a. assignments.
b. staffing.
c. output.
d. productivity.
ANS: B
Staffing is the activity of determining that an adequate number and mix of health care team
members are available to provide safe, high-quality patient care.

DIF: Comprehension REF: p. 367

9. A nurse manager is mentoring a novice nurse manager in determining staffing needs. The
mentor explains, “We must determine the acuity level of the patient by:
a.assessing patient satisfaction with nursing care.”
b.quantifying the amount and intensity of care required.”
c.examining the skill mix and educational preparation of the staff.”
d.determining the number of hospital days required by the patients.”
ANS: B
Patient acuity is measured by determining the amount and intensity of care required.

DIF: Comprehension REF: p. 367

10. The nurse manager is planning staffing levels and realizes that the first step is to:
a. know the intensity of care needed by patients according to physical and
psychosocial factors.
b. examine the educational level of the staff.
c. assess the skill level of caregivers.
d. review the budget to determine the financial consequences of past staffing patterns.
ANS: A
The nurse manager must determine the number and mix of health care providers according to
the wide range of care requirements of individual patients.

DIF: Application REF: p. 367

11. A hospital is concerned with nurse retention and realizes that job satisfaction is a major
influence. To enhance employee satisfaction related to staffing, the management team:
a. negotiates for additional agency nurses.
b. hires more part-time employees.
c. includes participatory management into staffing decisions.
d. uses “float” nurses to cover vacancies.
ANS: C
Staffing methods that include staff participation and enhance staff autonomy have been
demonstrated to play a major part in ensuring employee satisfaction.

DIF: Application REF: p. 368

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